Missed lab appointments don’t just delay care, they drive up costs, reduce capacity and frustrate patients. Providence, one of the nation’s largest nonprofit systems, tackled this head-on. The result? An 8-fold increase in lab appointment scheduling, reduced no-shows and a…
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Blue Cross Blue Shield of Massachusetts is expanding its claims review process to address what it is describing as potential overcoding among physicians who routinely bill for high-complexity visits. The new policy takes effect for dates of service on or…
Elevance Health has shared plans to potentially penalize hospitals and other contracted facilities that use care providers who are not in-network with its Anthem Blue Cross Blue Shield commercial plans in 11 states. Under the policy, finalized Oct. 1 and…
Optum has named Ben Eklo as its next chief financial officer, effective Nov. 1. Mr. Eklo has been with the company for 18 years, a spokesperson for UnitedHealth Group told Becker’s. He replaces Roger Connor, who was named CFO of…
James Brown, Montana state auditor and commissioner of securities and insurance, launched an investigation into Blue Cross and Blue Shield of Montana, a subsidiary of Health Care Service Corp., after a data breach that may have affected up to 462,000…
Abridge is now trusted by 200+ health systems to deliver results for clinicians, patients, and clinical and operational teams. While value is immediately evident from rapid adoption and positive clinician feedback after deployment of Abridge, discerning CMIOs, CIOs, and CFOs…
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Coverage for drugs recently approved by the FDA can take months to solidify, according to the Institute for Clinical and Economic Review’s “Launch Price and Access Report,” published Oct. 23. Researchers reviewed 24 drugs from Boston-based Tufts Medical Center’s specialty…
Molina Healthcare reported a 72% decline in net income for the third quarter and has reduced its adjusted annual earnings guidance for the third time this year to $14 a share as the company faces rising costs in its marketplace…
CMS Administrator Mehmet Oz, MD, told FOX 5 Atlanta that the government shutdown is not affecting Medicare open enrollment. “The shutdown is a problem for lots of parts of government but not for [Medicare] open enrollment,” he said. “Medicare is…
CMS mandates for interoperability, patient access and prior authorization — CMS-9115-F and CMS-0057-F — are fundamentally changing how payers and providers must share data, with enforcement deadlines extending into 2026. The good news: Compliance doesn’t necessarily require ripping and replacing…
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Presented by:
Joerg Schwarz
Senior Director for Healthcare Interoperability Solutions and Strategy, Infor
Chris Smith, MS
Enterprise Architect, Mississippi Division of Medicaid
